140 articles - From Friday Sep 23 2022 to Friday Sep 30 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Endoscopy |
Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. 16: ESGE recommends the use of NSBBs (propranolol or carvedilol) in combination with endoscopic therapy for secondary prophylaxis in EVH in patients with ACLD. Strong recommendation, high quality evidence. |
| Gastroenterology |
AGA Clinical Practice Update on Management of Refractory Celiac Disease: Expert Review. Identify local experts with expertise in celiac disease to assist with management. BEST PRACTICE ADVICE 10: Patients with refractory celiac disease without response to steroids may benefit from referral to a center with expertise for management or evaluation for inclusion in clinical trials. |
| Hepatology |
meta-analyses and systematic reviews
| Am J Gastroenterol |
Clinical Prediction Models for Pancreatic Cancer in General and At-Risk Populations: A Systematic Review. Many clinical risk prediction models for pancreatic cancer had been developed for different target populations. Although low risk of bias studies were identified, these require external validation and implementation studies to ensure these will benefit clinical decision making. |
| Endoscopy |
Accuracy of self-assessment in gastrointestinal endoscopy: a systematic review and meta-analysis. GI endoscopists are inaccurate in self-assessment of their endoscopic competency. Subgroup analyses demonstrated that novice and intermediate endoscopists were inaccurate, while expert endoscopists have accurate self-assessment. While we advise against the sole use of self-assessment among novice and intermediate endoscopists, expert endoscopists may wish to integrate it into their practice. |
| Neurogastroenterol Motil |
Association between eosinophilic esophagitis and esophageal dysmotility: A systematic review and meta-analysis. Non-specific motility disorders were common in patients with EoE, but major motility disorders were rare. Further studies are needed to determine the relationship between eosinophilic infiltration and the clinical relevance of abnormal esophageal motility findings in this population. |
Comparison of acid-lowering drugs for endoscopy negative reflux disease: Systematic review and network Meta-Analysis. Our results confirm superiority of PPIs compared with most other drugs in treating endoscopy-negative reflux disease. Future RCTs should aim to better classify patients with endoscopy-negative reflux disease, and to establish the role of alginates and PCABs in achieving symptom relief in both the short- and long-term. |
Diagnostic yield of colonoscopy for organic disease in irritable bowel syndrome and its risk factors: A meta-analysis. We provide the first pooled estimate of yield of colonoscopy in IBS and its risk factors, which may be used to inform clinical decision and support guidelines. |
Placebo response in pharmacological trials in patients with functional dyspepsia-A systematic review and meta-analysis. The pooled placebo response rate in pharmacological trials in FD is about 39%, depending on which responder definitions is used. Future trials should consider applying an entry criterion based on minimal level of symptom severity to decrease the placebo response. We also suggest separate reporting of core FD symptoms pending more concrete harmonization efforts in FD trials. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Gut metagenome-derived signature predicts hepatic decompensation and mortality in NAFLD-related cirrhosis. This study provides evidence for a gut metagenome-derived signature with high diagnostic accuracy for hepatic decompensation that predicts risk of mortality in NAFLD-related cirrhosis. |
Liver-transplant-free survival according to alkaline phosphatase and GLOBE score in patients with primary biliary cholangitis treated with ursodeoxycholic acid. The LT-free survival of patients with PBC with a normal GLOBE score is optimal in case of normal ALP levels, also in relation to the general population. Despite their generally favourable prognosis, an elevated ALP level may still indicate a need for add-on therapy. |
Oesophageal secretions reveal local food-specific antibody responses in eosinophilic oesophagitis. There is a distinct localised profile of immunoglobulins and food-specific antibodies found within oesophageal secretions in EoE. These findings expand our knowledge about the currently identified immune responses in EoE and suggest possible roles for multiple immunoglobulins and food-specific antibodies in the pathophysiology of EoE. |
Predictors of histologic response to dietary therapy in eosinophilic oesophagitis. In adults with EoE, histologic dietary non-response to SFED was associated with a higher pre-SFED EREF score, suggesting that fixed structural disease may predict dietary non-response. Our additional observations of poor correlation between symptomatic and histologic flares, and identification of ExSFED responders, suggest that histologic confirmation should be sought before committing patients to lifelong dietary changes. We also recommend the consideration of restricting legumes and corn in SFED non-responders as ExSFED detected additional dietary responders. |
Prevalence and clinical characteristics of patients with metabolic dysfunction-associated fatty liver disease with hepatitis C virus infection-a population-based study. Metabolic-associated fatty liver disease is highly prevalent in patients with HCV infection and has risen over time. This rising prevalence parallels the alarming rise in obesity, diabetes mellitus and hypertension. Early detection of metabolic dysfunction in patients with HCV infection is recommended to prevent MAFLD progression. |
Racial and ethnic differences in diet quality and food insecurity among adults with fatty liver and significant fibrosis: A U.S. population-based study. Among adults with NAFLD, White persons had poorer DQ than other races/ethnicities. The influence of food insecurity on DQ may be potentiated in this group. Exploration of the sociocultural factors influencing DQ is needed to mitigate NAFLD disparities. |
Randomised controlled trial: effects of gluten-free diet on symptoms and the gut microenvironment in irritable bowel syndrome. A gluten-free diet may influence symptoms in a subset of patients with IBS, with a particular effect on bowel habits. A gluten-free diet seems to impact the gut microenvironment. Responsiveness to the gluten-free diet may be predicted by the metabolite profile. NCT03869359. |
The efficacy and safety of adding on or switching to peginterferon a-2b in HBeAg-positive chronic hepatitis B patients with long-term entecavir treatment: A multicentre randomised controlled trial. In CHB patients who achieved virological response with long-term ETV treatment, both adding on and switching to PEG-IFN therapy are alternative strategies to result in higher rates of HBeAg seroconversion and higher HBsAg reduction compared with continuous ETV monotherapy. Clinical trials registration Chinese Clinical Trial Registry ( identifier ChiCTR-IPR-17012055). |
Trends in characteristics, management, and outcomes of patients presenting with gastrointestinal bleeding to emergency departments in the United States from 2006 to 2019. The incidence of GIB in the U.S. is increasing. UGIB incidence has been increasing since 2014 while LGIB incidence has been decreasing since 2015. Despite a more comorbid population in 2019, case fatality rate, length of stay and costs have decreased. More patients are discharged from the ED and the rate of RBC transfusions has decreased, possibly reflecting changing clinical practice in response to updated guidelines. |
Ustekinumab during pregnancy in patients with inflammatory bowel disease: a prospective multicentre cohort study. Pregnant patients with IBD treated with UST demonstrated favourable pregnancy and neonatal outcomes that were comparable with those in patients treated with anti-TNF or other therapy. Data are reassuring for patients with IBD and their physicians when considering UST during pregnancy. |
Validation of the Achalasia Patient-Reported Outcomes Questionnaire. The APRO is a reliable and valid measure of achalasia symptoms that addresses the limitations of existing questionnaires. Symptom anxiety and hypervigilance moderate the relationship between APRO and quality of life; 33% of patients with achalasia exhibit concerning patterns in symptom severity, anxiety and hypervigilance that may contribute to poorer outcomes. |
| Am J Gastroenterol |
An Expert Opinion/Approach: Clinical Presentations, Diagnostic Considerations, and Therapeutic Options for Gastrointestinal Manifestations of Common Variable Immune Deficiency. The inflammatory bowel disease like condition is usually treated with steroids, 5-aminosalicylates, thiopurines, or biologics to control the inflammation. In this review, the clinical presentations, diagnostic considerations, and therapeutic options for gastrointestinal manifestations of CVID will be discussed to facilitate individualized management of these often-complex patients. |
Eosinophilic Gastritis and Enteritis Are Increased in Families with Eosinophilic Esophagitis. The RR of EG/EGE is significant among relatives of EoE patients, suggesting shared genetic factors exist among these EGIDs. EG/EGE and EC showed limited familial clustering, although sample sizes were small. |
Quality Indicators for Capsule Endoscopy and Deep Enteroscopy. Comprehensive quality indicators have not existed for CE or DE. The task force identified quality indicators that can be incorporated into clinical practice. The panel also addressed existing knowledge gaps and posed research questions to better inform future research and quality guidelines for these procedures. |
| Clin Gastroenterol Hepatol |
High-dimensional clustering of 4000 Irritable Bowel Syndrome Patients reveals Seven Distinct Disease Subsets. In this cohort of older IBS patients, seven distinct clusters were identified demonstrating varying degrees of GI symptoms, comorbidities, dietary, and lifestyle factors. Further research is required to assess whether these unique clusters could be used to direct clinical trials and individualize patient management. |
I-CARE, a European prospective cohort study assessing safety and effectiveness of biologics in inflammatory bowel disease. I-CARE is an ongoing investigator-initiated observational European prospective cohort study that will provide unique information on the long-term benefits and risks of biological therapies in IBD patients. |
INTERRUPTION OF ANTI-THROMBOTIC THERAPIES AND RISK OF POST-COLONOSCOPY THROMBOEMBOLIC EVENTS: A REAL-WORLD COHORT STUDY. Temporary interruption of anti-thrombotic agents, particularly stopping =2 agents, clopidogrel, warfarin or DOAC was associated with higher post-colonoscopy TE events and even death, particularly in high risk patients. |
Non-Alcoholic Fatty Liver Disease Without Metabolic Associated Fatty Liver Disease and the Risk of Metabolic Syndrome. In this large cohort, participants with NAFLD without MAFLD were at higher risk of developing metabolic syndrome compared to participants with no NAFLD and no MAFLD. Using MAFLD criteria may miss opportunities for early intervention in these subjects. |
| Endoscopy |
Wide Area Transepithelial Sampling with Computer Assisted Analysis (WATS3D) to detect High Grade Dysplasia and Cancer in Barrett's esophagus: A Multi-Center, Randomized Study. Although the combination of WATS and FB increases dysplasia detection in a population of BE patients enriched for dysplasia, we did not find a statistically significant difference between WATS and FB for detection of HGD/EAC as single modality. |
| Gastroenterology |
Greater Transplant-free Survival in Patients Receiving Obeticholic Acid for Primary Biliary Cholangitis in a Clinical Trial Setting Compared to Real-World External Controls. Patients treated with OCA in a trial setting had significantly greater transplant-free survival than comparable external control patients. |
Human gut microbiota and its metabolites impact immune responses in COVID-19 and its complications. Multi-omics analysis revealed multiple gut microbe-metabolite-cytokine interrelationships in COVID-19 and COVID-19-related complications, but few in GI complications, suggesting microbiota-mediated immune responses distinct between the organ sites. Our results underscore the existence of a gut-lung axis in COVID-19. |
| Gastrointest Endosc |
Quality indicators for capsule endoscopy and deep enteroscopy. The task force identified quality indicators that can be incorporated into clinical practice. The panel also addressed existing knowledge gaps and posed research questions to better inform future research and quality guidelines for these procedures. |
| Gut |
CARD9 in neutrophils protects from colitis and controls mitochondrial metabolism and cell survival. These results provide new insight into the role of CARD9 in neutrophil mitochondrial function and its involvement in intestinal inflammation, paving the way for new therapeutic strategies targeting neutrophils. |
Early management of acute severe UC in the biologics era: development and international validation of a prognostic clinical index to predict steroid response. Emergency colectomy rates for ASC have halved in 25 years to 8%-15% worldwide. Patients who will not respond to corticosteroids are readily identified on admission and may be prioritised for early intensification of therapy. |
Harnessing the Vnn1 pantetheinase pathway boosts short chain fatty acids production and mucosal protection in colitis. The induction of Vnn1/VNN1 during colitis in mouse and human is a compensatory mechanism to reinforce the mucosal barrier. Therefore, enhancement of vitamin B5-driven metabolism should improve mucosal healing and might increase the efficacy of anti-inflammatory therapy. |
Postinfective bowel dysfunction following Campylobacter enteritis is characterised by reduced microbiota diversity and impaired microbiota recovery. The microbiota of PI-BD patients appeared more disturbed by the initial infection compared with the microbiota of those who recovered. The prebiotic effect of high fibre diets may inhibit some of the disturbances seen in PI-BD. |
| Hepatology |
Clinicogenomic characteristics and synthetic lethal implications of germline homologous recombination-deficient HCC. Our findings suggest that germline HR defects in HCC tend to confer a poor prognosis and result in distinctive genomic scarring. Tests of the clinical benefits of HR-directed treatments in the affected patients are needed. |
Glycemic burden and the risk of adverse hepatic outcomes in patients with chronic hepatitis B with type 2 diabetes. High glycemic burden was associated with HCC development and fibrosis progression among patients with CHB+T2D, highlighting the importance of glycemic control in reducing liver-related complications. |
Interleukin-33 facilitates liver regeneration through serotonin-involved gut-liver axis. Our study identified IL-33 is pro-regenerative in a non-injurious model of liver resection. The underlying mechanism involved IL-33/ST2-induced increase of serotonin release from enterochromaffin cells to portal blood and subsequent HTR2A/p70S6K activation in hepatocytes by serotonin. The findings implicate the potential of targeting IL-33/ST2/serotonin pathway to reduce the risk of post-hepatectomy liver failure and small-for-size syndrome. |
Silmitasertib Plus Gemcitabine and Cisplatin First-Line Therapy in Locally Advanced/Metastatic Cholangiocarcinoma: a Phase 1b/2 Study. Silmitasertib/G+C demonstrated promising preliminary evidence of efficacy for the first-line treatment of patients with locally advanced/metastatic cholangiocarcinoma. |
| J Hepatol |
A double-blind randomized placebo-controlled trial of albumin in patients with hepatic encephalopathy: HEAL study. In a double-blind, placebo controlled RCT of outpatients with cirrhosis, prior HE and current MHE, albumin infusions were associated with improved cognitive function and psychosocial quality of life likely through amelioration of endothelial dysfunction. |
Assessment of portal hypertension severity using machine learning models in patients with compensated cirrhosis. Internally-trained MLMs reliably predicted PH severity in the VIENNA cACLD cohort but exhibited heterogeneous results on external validation. The proposed 3P/5P online tool can reliably identify patients with CSPH or severe PH, thus, at risk for hepatic decompensation. |
Clinical features, outcomes, and HLA risk factors associated with nitrofurantoin-induced liver injury. NTF-DILI can result in parenchymal necrosis, bridging fibrosis, cirrhosis, and death or liver transplantation, especially with long-term exposure, and is associated with HLA-DRB1*11 04. For mitigating against serious liver injury associated with NTF, the regulators should revise the prescribing information and consider other mitigation strategies. |
Effect of variants in LGP2 on MDA5-mediated activation of interferon response and suppression of hepatitis D virus replication. LGP2 is essential to mount an antiviral IFN response induced by HDV and stabilizes MDA5-RNA interaction required for downstream signaling. The natural Q425R LGP2 is a gain-of-function variant and might contribute to an attenuated course of hepatitis D. |
Low utilization of adult-to-adult LDLT in Western countries despite excellent outcomes: international multicenter analysis of the US, UK, and Canada. The use of LDLT has remained low in United States, United Kingdom, and Canada countries. Despite this, long-term survival is excellent. Continued efforts to increase LDLT in these countries may be warranted due to the growing waitlist and differences in allocation that may disadvantage patients currently awaiting liver transplantation. |
National trends in retreatment of HCV due to reinfection or treatment failure in Australia. We used a novel methodology with high classification accuracy to evaluate DAA retreatment patterns at a national level. Increases in retreatment uptake for treatment failure corresponded to the availability of pangenotypic and salvage regimens. Increasing retreatment uptake for reinfection likely reflects increasing reinfection incidence. |
Reverse Inflammaging: Long-term effects of HCV cure on biological age. Our data contribute to the understanding of the biological impact of HCV elimination after DAA and demonstrate that HCV elimination can lead to "reverse inflammaging". In addition, we provide new conceptual ideas for the use of biological age as a potential biomarker for HCV sequelae after SVR. |
Severity of systemic inflammation is the main predictor of ACLF and bleeding in patients with acutely decompensated cirrhosis. Inflammation severity, and not coagulopathy, is the most important predictor of ACLF and bleeding in AD. The Padua model can be used to identify AD patients at risk of ACLF. |
| Neurogastroenterol Motil |
A prospective examination of swallow and cough dysfunction after lung transplantation. During the acute recovery period, al LT participants demonstrated some degree of unsafe swallowing and reduced voluntary cough strength. Silent aspirators exhibited elevated RR, reduced voluntary cough physiologic capacity to defend the airway, and a clinically distinguishable blunted motor response to reflex cough screening. |
Economic living standard and abdominal pain mediate the association between functional gastrointestinal disorders and depression or anxiety. In addition to the established associations between FGIDs and anxiety and depression, we have shown that the economic standard of living, pain, and IBS phenotype are significant independent covariates. This study demonstrates the range of lifestyle and demographic factors that modulate morbidity associated with FGIDs and may provide targets for intervention. |
Identifying hiatal hernia with impedance planimetry during esophageal distension testing. FLIP can detect HH with a substantial agreement with HRM, though esophageal distension with FLIP testing appeared to elicit and/or enlarge a HH in an additional 25% of patients. Although this unique response to esophageal distension may represent a mechanism of dysphagia or susceptibility to reflux, additional study is needed to clarify its significance. |
Visible abdominal distension in functional gut disorders: Objective evaluation. In most patients complaining of episodes of visible abdominal distention (A) the subjective claim is substantiated by objective evidence; (B) an increase in intestinal gas does not justify visible abdominal distention; (C) abdominophrenic dyssynergia is consistently evidenced by dynamic EMG recording, but static CT imaging has less sensitivity. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
Advancing human gut microbiota research by considering gut transit time. We argue that by taking into account the interindividual and intraindividual differences in gut transit time, we can advance our understanding of diet-microbiota interactions and disease-related microbiome signatures, since these may often be confounded by transient or persistent alterations in transit time. Altogether, a better understanding of the complex, bidirectional interactions between the gut microbiota and transit time is required to better understand gut microbiome variations in health and disease. |
Holistic healthcare in inflammatory bowel disease: time for patient-centric approaches? By pointing out intraoutcome and interoutcome concordance, we identified possible candidates for clinical adoption and further study in larger randomised clinical trials covering the broad spectrum of IBD heterogeneity. We finally proposed a patient-centric clinical care model and a series of recommendations for stakeholders, with special attention to complementary approaches and dietary strategies, aimed at achieving holistic remission. |
| Hepatology |
| J Hepatol |
Rational Development of Combination Therapies in Biliary Tract Cancers. Next generation sequencing is critical for direct patient care, as well in a research context to help clarify genomic mechanisms of resistance. Currently, multiple clinical trials at various stages are ongoing and this review seeks to provide an update on evolving standards of care and ongoing investigational agents, limitations to current treatments, and a framework for effective combination drug development for the future. |
| Neurogastroenterol Motil |
Achalasia: Current therapeutic options. The recent impressive advances in both the art and science of achalasia therapy are explored with a comprehensive review of the various treatment modalities and comparative controlled clinical trials. In addition, key technical pearls of the procedural treatments are demonstrated. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gut |
| Hepatology |
| J Hepatol |